Does she have a fever? What is her temperature? Questions like these induce fear in most new parents. The word fever is a trigger for worry and concern. It spawns many questions including: What is wrong with my child? Is she seriously ill? Could she have something seriously wrong with her? What do I need to do for her? Does she need to see the doctor? Does she need an antibiotic? What other signs of infection should I be looking for? Could the fever cause her to have a seizure? These are just a few of the many thoughts you will experience. These concerns and many others are healthy and appropriate. When concern is not managed and moderated worry replaces it and unhealthy consequences and patterns of behavior result. Your first step in this process is to learn about the causes and meaning of fever.
Fevers are healthy. A fever is an elevated body temperature above the normal baseline of 98.6 F. It represents your child’s physical response to stimuli inside or outside her body. Some fevers are caused by high ambient temperature or excess clothing. Infants do not shed heat as well as older children. Your infant does not sweat as well as older children and hence she does not cool herself as well via evaporation. Your body cools when water evaporates. Evaporation causes a net loss of energy and results in surface cooling. As humans we rely on sweating as a defense mechanism to prevent overheating. We sweat when our basal body temperature rises, when we exercise. or when we are placed in a warm environment. Blood vessels in the skin dilate and you become flushed. These are healthy responses and protect each of us. Infants, however, are less able to respond in this fashion and hence are more prone to environmental overheating. To help you decide whether your child’s fever is from overheating or something else the first step is to take her temperature and check out your surroundings. Is she overdressed for the environment or being exposed to excess radiant heat? Does she seem fussy and unsettled? Has she shown any other signs of illness? Feel her tummy and her toes. If both of them are overly warm she may be overheated. Take off her clothes down to the diaper and smile and talk to her. If she becomes more comfortable and playful you found your answer. You can even spritz her with tepid water to assist evaporation. More heat is lost by evaporation than by radiation or conduction. cool clothes can be placed on areas of her body where large blood vessels pass. These include her neck, groin and armpits. Such cooling is rarely needed. Misting with tepid water and fanning her is almost always enough unless severe overheating has occurred. These same strategies can be used if a high fever due to illness occurs.
If the fever is due to illness do not be scared. A fever is healthy. It is your daughter’s response to an infection. A fever enhances her body’s ability to fight off the infection. An elevated body temperature helps her body kill invading germs. Infants under 6 weeks of age, however, must be handled differently than older children when it comes to fever. If your infant under 2 months of age has a temperature over 100.5 F you must call your pediatrician. Young infants do not fight off infection as well as older infants. Your pediatrician will see your child and decide if any testing is needed. In children under 6-8 weeks of age extensive tests may need to be done including blood tests, urine tests and spinal fluid tests. Often these infants are admitted to the hospital and are placed on intravenous antibiotics for several days while waiting for culture results. Almost always the final diagnosis is a viral illness but the risk for a bacterial infection must always be considered.
For infants and children over 2 months the most important thing for you to do is relax, breathe and look at your child. Do a quick survey. How she is acting? Has she been eating well? Does she have any breathing difficulty? Has she been coughing? Has there been any change in her urine production or urine quality. Does she seem irritable or is she smiling and happy? Does she have a clear runny nose? Are other household members ill with colds? These questions will help you decide if you need to call the pediatrician. If the temperature is greater than 101F or climbing then you should call your pediatrician. If it is low grade and you see no warning signs then sit back, try to relax, and talk to your baby. Take her clothes off down to the diaper and recheck the temperature in 30 minutes. You do not need to give tylenol or ibuprofen. Most low grade fevers are due to minor viral infections that require no treatment. If your intuition tells you to call or your child shows irritability, poor feeding or breathing issues then always call your pediatrician. Temperature is not as important as the other signs and symptoms. If in doubt, always call. Reassurance is the best medicine. As your child and your experience grow you will soon be giving advice to other parents.